This is a competing renewal application for a K24 Career Award in Patient-Oriented Research. The candidate, Dr. David Steffens, is Professor of Psychiatry and Medicine at Duke University Medical Center, where he serves as the Head of the Division of Geriatric Psychiatry and Director of an NIMH-sponsored T32 Research Training Program. Dr. Steffens has established a record of scholarship in the area of geriatric depression, and he serves as Principal Investigator on two large NIMH-funded grants, an R01 focusing on longitudinal geriatric depression outcomes and on the Recruitment Core of a Conte Neuroscience Center studying cerebrovascular disease in late-life depression. He is the previous recipient of a Clinical Geriatric Mental Health Academic Award (K07). Dr. Steffens has mentored individuals at all levels, including undergraduates, graduate students, medical students, pre- and post-doctoral research fellows, psychiatry residents, geriatric psychiatry fellows, and junior faculty. These experiences make the candidate well qualified for this K24 Award. Through this Award, the candidate will expand his research by focusing on genes related to folate metabolism in late life depression. Using his funded research as a source for teaching, the candidate will be well positioned to mentor pre-doctoral and post-doctoral fellows as well as junior faculty. Under the Award, the candidate will spend at least 50% of his time conducting patient-oriented research and mentoring.